Lake-centred sedentary lifestyle of early Tibetan Plateau Indigenous populations at high elevation 4,400 years ago.

The onset of sedentism on the Tibetan Plateau is often presumed to be associated with the dispersal of agriculture or farmers from archaeological sites located in the low elevation margins of the plateau. Previous studies of the plateau assumed that all foragers were probably mobile, but few systematic excavations at forager sites have been conducted to inform us about their settlement patterns. Here we report the world's highest elevation sedentary way of living exhibited by the Mabu Co site at 4,446 metres above sea level, deep in the interior of the Tibetan Plateau 4,400-4,000 years ago. Our interdisciplinary study indicates that the site was occupied by Indigenous inhabitants of the plateau, representing the earliest known DNA evidence of foragers who predominantly harbour the southern plateau ancestry. The evidence shows that they had a sedentary lifestyle primarily supported by fishing at nearby lakes, supplemented by mammal and bird hunting, as well as small-scale exchanges of millet and rice crops.

Ridge planting increases the rhizosphere microbiome diversity and improves the yield of Pinellia ternata (Thunb.) Breit in North China.

Pinellia ternata (Thunb.) Breit is an important traditional Chinese medicine. In North China, conventional flat planting of P. ternate is prone to root rot during the rainy season, leading to severe yield loss. Variations in planting patterns (e.g., ridge planting) can effectively alleviate this situation. However, the relationship between planting patterns and the changes induced by rhizosphere microbiome still needs to be determined. In this study, we clarified the effect of ridge planting on the yield of P. ternata and rhizosphere microbial community using high-throughput amplicon sequencing of 16S rRNA. Field experiments showed that ridge planting could increase the yield of P. ternata by 72.69% compared with flat planting. The high-throughput sequencing results demonstrated that fungal and bacterial communities in rhizosphere siols of flat and ridge planting showed obvious difference in diversity, structure, relative abundance, and community composition. The fungal phyla Zygomycota, Basidiomycota, Glomeromycota, and the bacterial phyla Chlamydiae, Tenericutes, and Hydrogenedentes were present in a higher relative abundance in the rhizosphere of ridge planting. Adonis multivariate analysis of variance results showed that 29 bacterial genera were significantly up/down-regulated, and only 4 fungal genera were changed considerably in ridge planting soil, indicating that the bacterial community composition varied significantly between the two treatments. Correlation analysis revealed that the yield of P. ternata was positively correlated with fungal genera Emericellopsis while negatively correlated with bacterial genera Acetobacter, Iamia, and fungal genera Thielavia. Overall, this study showed that ridge cropping significantly impacts the diversity and composition of the rhizosphere microbiome. It creates an environment favorable for crop growth and can be an effective planting strategy for P. ternata in areas with irrigation and high monsoon rainfall in North China.

Intramedullary nailing for floating knee injury complicated by pulmonary fat embolism: A case report and literature review.

A 28-year-old man involved in a serious motorcycle accident was admitted to our hospital with comminuted fractures of the ipsilateral femoral shaft and tibial shaft, as well as multiple fractures of the right lower limb, including the proximal fibula, medial malleolus, and the third and fourth distal metatarsals. In addition, the patient suffered a skin contusion and laceration of the right foot. On the first day of admission, this patient suddenly developed tachycardia, pyrexia, and tachypnoea, and was immediately transferred to the ICU for further treatment due to a CT-diagnosed pulmonary fat embolism (FE). As a symptomatic treatment, he received a prophylactic dose of low-molecular-weight heparin for 10 days, after which his condition improved. A Doppler ultrasound of the lower leg and a follow-up chest CT angiography were performed, which excluded any remaining thrombus and verified that the pulmonary FE had improved without deterioration. Closed-reduction and retrograde intramedullary nailing were performed for the femoral shaft fractures, while antegrade intramedullary nailing was performed for the tibial shaft fractures under general anaesthesia. In the three-year follow-up, the patient had recovered with good function of the right limb, without any respiratory discomfort. Both the femoral and tibial shaft fractures finally resolved without any further treatment. Ipsilateral femoral and tibial shaft fractures should undergo surgical stabilisation as early as possible to avoid pulmonary FEs. It is still controversial whether intramedullary nailing is suitable for floating knee injuries complicated by pulmonary FEs. However, if patients with pulmonary FEs require intramedullary nailing, we suggest that surgery should be performed after at least one week of anticoagulant use, when patient vital signs are stable and there is no sign of dyspnoea. In addition, patients should try to avoid reaming during the operation to prevent and decrease "second hit" for the lung.

The Lethal and Sublethal Effects of Lambda-Cyhalothrin and Emamectin Benzoate on the Soybean Pest Riptortus pedestris (Fabricius).

Riptortus pedestris (Fabricius, 1775) (Hemiptera: Alydidae) is a major soybean pest in East Asia that can cause soybean staygreen syndrome. To date, no insecticides have been registered for the control of R. pedestris in China, and these insects are primarily controlled in the field through the application of broad-spectrum insecticides including lambda-cyhalothrin (LCT) and emamectin benzoate (EMB). Here, the lethal and sublethal effects of LCT and EMB on R. pedestris were comprehensively evaluated. LCT and EMB were both found to exhibit high levels of toxicity and concentration-dependent repellent effects for R. pedestris. The exposure of third instar nymphs from the F0 generation to LC30 concentrations of LCT and EMB resulted in a significant increase in the duration of nymph development and adult pre-oviposition period (APOP), together with reductions in fifth instar nymph and adult body weight, longevity, oviposition days, fecundity, vitellarium length, lateral oviduct diameter, and vitellogenin (Vg) gene expression as compared to control treatment. Strikingly, these suppressive effects were transmitted to the F1 generation, which similarly experienced the prolongation of preadult development and the preoviposition period (TPOP). Relative to control-treated populations, the F1 generation for these insecticide-treated groups also exhibited significant decreases in population parameter values. Overall, these data offer new insight into the impact that LCT and EMB treatment can have on R. pedestris, providing a valuable foundation for the application of these pesticides in the context of integrated pest management strategies aimed at soybean crop preservation.

Identification of highly active compounds from insecticidal plant Oroxylum indicum L. (Vent.) and the induction of apoptosis by lapachol on Sf9 cells.

The extraction of biopesticides from plants has become a promising field for agricultural development. To explore a high-efficiency and viable method for the screening of plant compounds with insecticidal activity, we screened for active ingredients in the insecticidal plant, Oroxylum indicum L. Vent, using Sf9 cells. A CCK-8 cytotoxicity assay kit was used for high-throughput screening of 34 compounds contained in O. indicum. The apoptosis-inducing effect of the highly cytotoxic compound on Sf9 cells was investigated by morphological characterization using inverted microscopy, caspase-3 activity assay, and DNA gel electrophoresis. Finally, the biological activity of compounds against aphids was evaluated using the leaf-pest dipping methods and leaf dipping methods. Results showed that among the main compounds identified, lapachol, chrysin, and baicalein had good proliferation inhibitory effects on Sf9 cells, with their recorded IC50 being 11.53 mg/L, 38.39 mg/L, and 42.10 mg/L, respectively. Moreover, the IC50 value of lapachol was lower than the control insecticides rotenone (18.03 mg/L) and fipronil (21.04 mg/L). Apoptosis assay further showed that lapachol promoted the production of caspase-3 and led to DNA fragmentation in Sf9 cells. Lapachol showed high biological activity against Aphis gossypii, Sitobion avenae, and Semiaphis heraclei, with its recorded LC50 being 104.40, 101.80, and 110.29 mg/L, respectively, which were comparable to the activity of the control insecticide rotenone. High-throughput screening of active ingredients in the insecticidal plant O. indicum using Sf9 cells is feasible, and the identification of lapachol as the main aphidicidal active substance is valuable for further study.

The associations of alcoholic liver disease and nonalcoholic fatty liver disease with bone mineral density and the mediation of serum 25-Hydroxyvitamin D: A bidirectional and two-step Mendelian randomization.

BACKGROUND: Reduced bone mineral density (BMD) and osteoporosis are common in chronic liver diseases. However, the causal effect of alcoholic liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD) on BMD remains uncertain. OBJECTIVES: This study uses a two-sample Mendelian randomization (MR) design to evaluate the genetically predicted effect of ALD and NAFLD on BMDs using summary data from publically available genome-wide association studies (GWASs). METHODS: The GWAS summary statistics of ALD (1416 cases and 213,592 controls) and NAFLD (894 cases and 217,898 controls) were obtained from the FinnGen consortium. BMDs of four sites (total body, n = 56,284; femoral neck, n = 32,735; lumbar spine, n = 28,498; forearm, n = 8143) were from the GEnetic Factors for OSteoporosis Consortium. Data for alcohol consumption (n = 112,117) and smoking (n = 33,299) and serum 25-Hydroxyvitamin D (25-OHD) level (n = 417,580) were from UK-biobank. We first performed univariate MR analysis with the Inverse Variance Weighted (IVW) method as the primary analysis to investigate the genetically predicted effect of ALD or NAFLD on BMD. Then, multivariate MR and mediation analysis were performed to identify whether the effect was mediated by alcohol consumption, smoking, or serum 25-OHD level. RESULTS: The MR results suggested a robust genetically predicted effect of ALD on reduced BMD in the femoral neck (FN-BMD) (IVW beta = -0.0288; 95% CI: -0.0488, -0.00871; P = 0.00494) but not the other three sites. Serum 25-OHD level exhibited a significant mediating effect on the association between ALD and reduced FN-BMD albeit the proportion of mediation was mild (2.21%). No significant effects of NAFLD, alcohol consumption, or smoking on BMD in four sites, or reverse effect of BMD on ALD or NAFLD were detected. CONCLUSION: Our findings confirm the genetically predicted effect of ALD on reduced FN-BMD, and highlight the importance of periodic BMD and serum 25-OHD monitoring and vitamin D supplementation as needed in patients with ALD. Future research is required to validate our results and investigate the probable underlying mechanisms.

Detoxification enzyme is involved in the temperature effect on the toxicity of tetrachlorantraniliprole to Plutella xylostella.

The efficacy of insecticides is usually influenced by temperature. Insecticides can be divided into "positive", "negative" and "non-effect" temperature coefficient insecticides (TCI). To assess the temperature-dependent effect of tetrachlorantraniliprole (TET) on Plutella xylostella Linnaeus and to elucidate the mechanism of temperature affects TET toxicity, we determined the toxicity of TET against P. xylostella from 15 °C to 35 °C by leaf dipping method. Moreover, we compared the transcriptome data of the third-instar larvae treated by TET, chlorfenapyr (CHL, non-effect TCI), and the control group at 15, 25, 35 °C, respectively. The results showed that the toxicity of TET against P. xylostella increased with increasing temperature from 15 °C to 35 °C. A total of 21 differential expressed genes (DEGs) of detoxification enzymes were screened by RNA-seq, in which 10 up-regulated genes (3 UGTs, 2 GSTs, 5 P450s) may involve the positive temperature effect of TET, and their expression patterns were consistent with qPCR results. Furthermore, the enzyme activities of GSTs and UGTs significantly increased after TET was treated at 15 °C. Especially, the temperature coefficient (TC) of TET was significantly reduced mixed with UGTs enzyme inhibitor 5-NI. Overall, TET showed higher insecticidal activity with increasing temperature, in which detoxifying enzymes associated with regulation of the positive temperature effect of TET on P. xylostella, such as UGTs, GSTs and P450s, are strongly involved. The transcriptome data provide in-depth information to understand the TET mechanism against diamondback moth. Most importantly, we identified detoxification enzymes that might be involved in regulating TET's positive temperature effect process, and contributed to efficient pest management.

Comparative analyses of the effects of sublethal doses of emamectin benzoate and tetrachlorantraniliprole on the gut microbiota of Spodoptera frugiperda (Lepidoptera: Noctuidae).

Spodoptera frugiperda (J. E. Smith) is an important invasive pest that poses a serious threat to global crop production. Both emamectin benzoate (EB) and diamide insecticides are effective insecticides used to protect against S. frugiperda. Here, 16S rRNA sequencing was used to characterize the gut microbiota in S. frugiperda larvae exposed to EB or tetrachlorantraniliprole (TE). Firmicutes and Proteobacteria were found to be the dominant bacterial phyla present in the intestines of S. frugiperda. Following insecticide treatment, larvae were enriched for species involved in the process of insecticide degradation. High-level alpha and beta diversity indices suggested that exposure to TE and EB significantly altered the composition and diversity of the gastrointestinal microbiota in S. frugiperda. At 24 h post-EB treatment, Burkholderia-Caballeronia-Paraburkholderia abundance was significantly increased relative to the control group, with significant increases in Stenotrophobacter, Nitrospira, Blastocatella, Sulfurifustis, and Flavobacterium also being evident in these larvae. These microbes may play a role in the degradation or detoxification of EB and TE, although further work will be needed to explore the mechanisms underlying such activity. Overall, these findings will serve as a theoretical foundation for subsequent studies of the relationship between the gut microbiota and insecticide resistance in S. frugiperda (J. E. Smith) (Lepidoptera: Noctuidae).

Genome-wide identification of candidate chemosensory receptors in the bean bug Riptortus pedestris (Hemiptera: Alydidae) and the functional verification of its odorant receptor co-receptor (Orco) in recognizing aggregation pheromone.

A sophisticated and sensitive olfactory system plays a vital role in the survival and reproduction of insects. Chemosensory receptors are indispensable for the molecular recognition and discrimination of semiochemicals. Riptortus pedestris is a notorious pest of legume plants, resulting in yield losses and quality decreases in soybeans. It is well accepted that R. pedestris highly relies on its olfactory system in detecting aggregation pheromones, host volatiles, and pesticides; however, little research focused on its chemosensory receptors. In the present study, we identified 237 odorant receptors (ORs), 42 gustatory receptors (GRs), and 31 ionotropic receptors (IRs) from the reported genome of R. pedestris, and analyzed their phylogenetic relationship with other hemipteran species. Through the results of RNA-seq and real-time quantitative PCR (qRT-PCR), we found that RpedORs displayed different expression levels in the antennae of R. pedestris at different development stages. To further verify the function of odorant receptor co-receptor (Orco), an obligate and unique insect OR, we silenced RpedOrco by RNA interference (RNAi) method. The results showed that silencing RpedOrco could significantly impair the response to aggregation pheromone in R. pedestris, indicating that RpedOrco plays an essential role in odorant detection. Our results can provide the theoretical foundations for revealing the olfactory recognition mechanism of R. pedestris and help explore and develop novel olfactory-based agents against this pest.

Serum vitamin C levels and risk of non-alcoholic fatty liver disease: results from a cross-sectional study and Mendelian randomization analysis.

Background and aims: Vitamin C, as an antioxidant, may play a role in the treatment of NAFLD. This research aimed to investigate the association of serum vitamin C levels with the risk of NAFLD and to further examine the causal relationship by Mendelian randomization (MR) method. Methods: The cross-sectional study selected 5,578 participants of the National Health and Nutrition Examination Survey (NHANES), 2005-2006 and 2017-2018. The association of serum vitamin C levels with NAFLD risk was evaluated under a multivariable logistic regression model. A two-sample MR study, using genetic data from large-scale genome-wide association studies (GWAS) of serum vitamin C levels (52,014 individuals) and NAFLD (primary analysis: 1,483 cases /17,781 controls; secondary analysis: 1,908 cases/340,591 controls), was conducted to infer causality between them. The inverse-variance-weighted (IVW) was applied as the main method of MR analysis. A series of sensitivity analyzes were used to evaluate the pleiotropy. Results: In the cross-sectional study, results showed that Tertile 3 group (Tertile 3: ≥1.06 mg/dl) had a significantly lower risk (OR = 0.59, 95% CI: 0.48 ~ 0.74, p < 0.001) of NAFLD than Tertile 1 group (Tertile 1: ≤0.69 mg/dl) after full adjustments. In regard to gender, serum vitamin C was protective against NAFLD in both women (OR = 0.63, 95% CI: 0.49 ~ 0.80, p < 0.001) and men (OR = 0.73, 95% CI: 0.55 ~ 0.97, p = 0.029) but was stronger among women. However, in the IVW of MR analyzes, no causal relationship between serum vitamin C levels and NAFLD risk was observed in the primary analysis (OR = 0.82, 95% CI: 0.47 ~ 1.45, p = 0.502) and secondary analysis (OR = 0.80, 95% CI: 0.53 ~ 1.22, p = 0.308). MR sensitivity analyzes yielded consistent results. Conclusion: Our MR study did not support a causal association between serum vitamin C levels and NAFLD risk. Further studies with greater cases are warranted to confirm our findings.

Pollen Molecular Identification from a Long-Distance Migratory Insect, Spodoptera exigua, as Evidenced for Its Regional Pollination in Eastern Asia.

Understanding plant-insect interactions requires the uncovering of the host plant use of insect herbivores, but such information is scarce for most taxa, including nocturnal moth species, despite their vital role as herbivores and pollinators. In this study, we determined the plant species visited by an important moth species, Spodoptera exigua, by analyzing attached pollen on migratory individuals in Northeast China. Pollen grains were dislodged from 2334 S. exigua long-distance migrants captured between 2019 and 2021 on a small island in the center of the Bohai Strait, which serves as a seasonal migration pathway for this pest species, and 16.1% of the tested moths exhibited pollen contamination, primarily on the proboscis. Subsequently, 33 taxa from at least 23 plant families and 29 genera were identified using a combination of DNA barcoding and pollen morphology, primarily from the Angiosperm, Dicotyledoneae. Moreover, the sex, inter-annual, and seasonal differences in pollen adherence ratio and pollen taxa were revealed. Notably, compared to previously reported pollen types found on several other nocturnal moths, we found that almost all of the above 33 pollen taxa can be found in multiple nocturnal moth species, providing another important example of conspecific attraction. Additionally, we also discussed the indicative significance of the pollen present on the bodies of migratory individuals for determining their migratory route. Overall, by delineating the adult feeding and pollination behavior of S. exigua, we advanced our understanding of the interactions of the moths with their host plants, and its migration pattern, as well as facilitated the design of (area-wide) management strategies to preserve and optimize ecosystem services that they provide.

Multifunctional Soft Stackable Robots by Netting-Rolling-Splicing Pneumatic Artificial Muscles.

Soft robots equipped with multifunctionalities have been increasingly needed for secure, adaptive, and autonomous functioning in unknown and unpredictable environments. Robotic stacking is a promising solution to increase the functional diversity of soft robots, which are required for safe human-machine interactions and adapting in unstructured environments. However, most existing multifunctional soft robots have a limited number of functions or have not fully shown the superiority of the robotic stacking method. In this study, we present a novel robotic stacking strategy, Netting-Rolling-Splicing (NRS) stacking, based on a dimensional raising method via 2D-to-3D rolling-and-splicing of netted stackable pneumatic artificial muscles to quickly and efficiently fabricate multifunctional soft robots based on the same, simple, and cost-effective elements. To demonstrate it, we developed a TriUnit robot that can crawl 0.46 ± 0.022 body length per second (BL/s) and climb 0.11 BL/s, and can carry a 3 kg payload while climbing. Also, the TriUnit can be used to achieve novel omnidirectional pipe climbing including rotating climbing, and conduct bionic swallowing-and-regurgitating, multi-degree-of-freedom manipulation based on their multimodal combinations. Apart from these, steady rolling, with a speed of 0.19 BL/s, can be achieved by using a pentagon unit. Furthermore, we applied the TriUnit pipe climbing robot in panoramic shooting and cargo transferring to demonstrate the robot's adaptability for different tasks. The NRS stacking-driven soft robot here has demonstrated the best overall performance among existing stackable soft robots, representing a new and effective way for building multifunctional and multimodal soft robots in a cost-effective and efficient way.

Comparative genome and phylogenetic analysis revealed the complex mitochondrial genome and phylogenetic position of Conopomorpha sinensis Bradley.

Conopomorpha sinensis Bradley is a destructive pest that causes severe economic damage to litchi and longan. Previous C. sinensis research has focused on population life tables, oviposition selectivity, pest population prediction, and control technology. However, there are few studies on its mitogenome and phylogenetic evolution. In this study, we sequenced the whole mitogenome of C. sinensis by the third-generation sequencing, and analyzed the characteristics of its mitogenome by comparative genome. The complete mitogenome of C. sinensis is a typical circular and double-stranded structure. The ENC-plot analyses revealed that natural selection could affect the information of codon bias of the protein-coding genes in the mitogenome of C. sinensis in the evolutionary process. Compared with 12 other Tineoidea species, the trnA-trnF gene cluster of tRNA in the C. sinensis mitogenome appears to have a new arrangement pattern. This new arrangement has not been found in other Tineoidea or other Lepidoptera, which needs further exploration. Meanwhile, a long AT repeated sequence was inserted between trnR and trnA, trnE and trnF, ND1 and trnS in the mitogenome of C. sinensis, and the reason for this sequence remains to be further studied. Furthermore, the results of phylogenetic analysis showed that the litchi fruit borer belonged to Gracillariidae, and Gracillariidae was monophyletic. The results will contribute to an improved understanding of the complex mitogenome and phylogeny of C. sinensis. It also will provide a molecular basis for further research on the genetic diversity and population differentiation of C. sinensis.

Ipsilateral comminuted distal radius and comminuted radial head fractures with posterolateral elbow dislocation: A case report and literature review.

We report an uncommon case of ipsilateral comminuted distal radius and comminuted radial head fractures with posterolateral elbow dislocation. A 51-year-old female had a fall that resulted in a comminuted distal radius fracture with an ipsilateral comminuted radial head fracture and posterolateral dislocation of the elbow. Clinical evaluation revealed that her left elbow was posteriorly dislocated and her left wrist was deformed. Plain radiographs showed an intraarticular fracture of the distal end of the radius and a comminuted radial head fracture with a proximally migrated radius. Magnetic resonance imaging (MRI) also showed lateral ulnar collateral ligament injuries. We addressed her distal radius with an anatomical locking plate and then treated her comminution radial head fracture with a radial head replacement. Postoperative radiographs showed a good reduction. The Cooney score was 90 at one year postoperatively.

Stable Isotopes Indicate Seasonal Changes in Natal Geographic Origins and Host Plants of Ostrinia furnacalis (Guenée) Migrants Across the Bohai Strait in China.

The Asian corn borer, Ostrinia furnacalis (Guenée), is a notorious pest of maize that migrates seasonally in Asia. Two migration peaks were found on Beihuang island in the Bohai Strait of China by observing the number of migrants. However, the origins and host plants of the migrants in the two migration periods remain unclear. Here, stable hydrogen (δ2H) and carbon (δ13C) isotope levels were measured to infer the origin and host plants of the O. furnacalis captured on Beihuang island in 2017-2019. δ2H in wings of spring-summer O. furnacalis captured from May to June ranged from -99 to -56‰, while that of autumn migrants from August to September ranged from -127 to -81‰. Based on the linear relationship between δ2H in the wing of migrants (δ2Hw) and δ2H in precipitation (δ2Hp), the spring-summer O. furnacalis likely originated from the summer maize area in the Huang-Huai-Hai Plain in China. In contrast, the autumn migrants came from the northern spring maize area in Liaoning, Jilin and Inner Mongolia. Based on δ13C, the spring-summer migrants fed on both C3 plants such as wheat (47.76%) and C4 weeds or belonged to the over winter individuals in maize field (52.24%), while the autumn migrants mainly fed on maize (C4, 91.21%). The results point to a northward migration in spring-summer and southward migration in autumn of O. furnacalis. Our study gives an important knowledge for improving the forecasting and management level of this pest.

A cross-sectional study on the effect of dietary zinc intake on the relationship between serum vitamin D3 and HOMA-IR.

Introduction: Serum vitamin D3 concentration is associated with the risk of insulin resistance. Zinc has also been reported to be associated with a lower risk of insulin resistance. In addition, zinc is an essential cofactor in the activation of vitamin D3. However, the effect of dietary zinc intake on the relationship between vitamin D3 and insulin resistance risk has not been fully studied. Therefore, we designed this cross-sectional study to assess the impact of changes in zinc intake on the relationship between vitamin D3 and insulin resistance risk. Study design and methods: This study analyzed data from the national Health and Nutrition Examination Survey (NHANES) from 2005 to 2018, involving 9,545 participants. Participants were stratified by zinc intake category (low zinc intake <9.58 mg/ day; High zinc intake: ≥9.58 mg/ day). Results: In this cross-sectional study, serum vitamin D3 levels were independently associated with the risk of insulin resistance in both the low and high Zinc intakes (ß: -0.26, 95%Cl: -0.56~0.04 vs. ß: -0.56, 95%Cl: -1.01~-0.11). In addition, this association was influenced by different dietary zinc intakes (interaction P < 0.05). Conclusions: Our results suggest that zinc intake may influence the association between serum vitamin D3 and the risk of insulin resistance. Further randomized controlled trials are needed to provide more evidence of this finding.

Comparing the effectiveness of 3D printing technology in the treatment of clavicular fracture between surgeons with different experiences.

PURPOSE: This study aims to examine the use of 3D printing technology to treat clavicular fractures by skilled and inexperienced surgeons. METHODS: A total of 80 patients with clavicle fractures (from February 2017 to May 2021) were enrolled in this study. Patients were divided randomly into four groups: group A: Patients underwent low-dose CT scans, and 3D models were printed before inexperienced surgeons performed surgeries; group B: Standard-dose CT were taken, and 3D models were printed before experienced surgeons performed surgeries; group C and D: Standard-dose CT scans were taken in both groups, and the operations were performed differently by inexperienced (group C) and experienced (group D) surgeons. This study documented the operation time, blood loss, incision length, and the number of intraoperative fluoroscopies. RESULTS: No statistically significant differences were found in age, gender, fracture site, and fracture type (P value: 0.23-0.88). Group A showed shorter incision length and fewer intraoperative fluoroscopy times than groups C and D (P < 0.05). There were no significant differences in blood loss volume, incision length, and intraoperative fluoroscopy times between group A and group B (P value range: 0.11-0.28). The operation time of group A was no longer than those of groups C and D (P value range: 0.11 and 0.24). CONCLUSION: The surgical effectiveness of inexperienced surgeons who applied 3D printing technology before clavicular fracture operation was better than those of inexperienced and experienced surgeons who did not use preoperative 3D printing technology.